NPIMap

Individual provider Active NPI

Basem Mourad Labib Mishriky, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Columbia, SC
National Provider Identifier
1326486465
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
87142 Issued in SC
Practice address
2 Medical Park Rd Ste 506
Columbia, SC 29203-6876
Phone
(803) 434-3930
Fax
(803) 540-1050
NPI assigned
Jun 11, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2017-00499 NC
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 87142 SC Primary

Addresses

Primary practice location

2 Medical Park Rd Ste 506
Columbia, SC 29203-6876

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other identifiers 3

IdentifierTypeStateIssuer
1326486465MedicaidNC
NCX458AOtherNCMEDICARE
19QHEOtherNCBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170627000580 NC Practitioner - Internal Medicine 1951609536 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

101 SW Cary Pkwy
Cary, NC 27511-5562
Phone (919) 467-7678

2701 Pickett Rd
Durham, NC 27705-5688
Phone (919) 419-9600

7200 Creedmoor Rd
Suite 208
Raleigh, NC 27613-1711
Phone (919) 327-1650

Hospital & facility affiliations

  • Duke Home Health Home health agency, Durham, NC, CCN 347136
  • Pruitthealth at Home - Wake Home health agency, Raleigh, NC, CCN 347251
  • Amedisys Home Health Home health agency, Durham, NC, CCN 347110
  • Centerwell Home Health Home health agency, Raleigh, NC, CCN 347178
  • Medi Home Health Agency Home health agency, Raleigh, NC, CCN 347237
  • Duke University Hospital Hospital, Durham, NC, CCN 340030
  • Duke Regional Hospital Hospital, Durham, NC, CCN 340155

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2017-00499NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Duke University Affiliated Physicians, Inc. Internal Medicine CurrentSince Jul 10, 2023 Accepting new patients
Duke University Affiliated Physicians, Inc. Current Accepting new patients
Duke University Affiliated Physicians, Inc. Internal Medicine Current Accepting new patients
Duke University Affiliated Physicians, Inc. Internal Medicine CurrentSince Jul 10, 2023 Accepting new patients
Duke University Affiliated Physicians, Inc. Past Accepting new patients
East Carolina University PastSince Jul 1, 2017 Accepting new patients

Locations

2503 E Lyon Station Rd
Creedmoor, NC 27522
Phone (919) 528-1535

7200 Creedmoor Rd
Ste 208
Raleigh, NC 27613
Phone (919) 327-1650

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1370908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1326486465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MEDICAL PARK RD STE 506",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036876",
            "telephone_number": "803-434-3930",
            "fax_number": "803-540-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISHRIKY",
        "first_name": "BASEM",
        "middle_name": "MOURAD LABIB",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-11",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2017-00499",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "SC",
            "license": "87142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326486465",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "NCX458A",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "19QHE",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.